A tumor is an abnormal growth of cells that results in a mass of tissue that can occur anywhere in the body. When a tumor forms in the pituitary gland, it is referred to as a pituitary tumor. Most of these types of tumors are benign (noncancerous). However, since the pituitary gland regulates some of the body’s hormones, a tumor can affect hormone production, causing a significant increase or decrease in levels of specific hormones.
These tumors that do not produce hormones are referred to as nonfunctioning. The tumors that produce hormones are referred to as functioning. Functioning tumors can affect the following hormones:
- Adrenocorticotropic hormone (ACTH)
- Growth hormone
- Thyroid-stimulating hormone
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What Causes Pituitary Tumors?
Doctors do not know what causes pituitary tumors to develop. However, scientists have discovered that individuals diagnosed with a condition called multiple endocrine neoplasia type I (MEN 1) are at an increased risk of developing pituitary tumors.
Symptoms of Pituitary Tumors
They can grow slowly, and most may not even cause any symptoms. Additionally, the symptoms depend on the type of tumor present.
Individuals with a nonfunctioning tumor may experience the following symptoms:
- Vision problems
Individuals with a functioning tumor may experience the following symptoms:
- Hormone deficiency
- Excess hormones
- Nausea and/or vomiting
- Weight gain
- Changes in mood, such as depression, irritability, and/or anxiety
- Muscle weakness
- Decreased libido
- Cushing’s disease
- In women, irregular menstruation
What to Expect at Your Appointment
During your appointment, your doctor will ask you to thoroughly describe your symptoms and will want to discuss your medical history. If your doctor suspects that a pituitary tumor may be causing your symptoms, he/she will want to perform diagnostic testing. Some of the tests used to diagnose a pituitary tumor include:
- Pituitary functioning hormone test - This is a blood test used to determine whether the pituitary tumor is functioning (producing hormones) or nonfunctioning (not producing hormones).
- Blood and urine test - These tests are used to detect overproduction or underproduction of various hormones. Your doctor may also want to conduct imaging tests, such as an MRI or CT scan in order to locate and determine the size of the pituitary tumor.
Non-surgical Treatments for Pituitary Tumors
If necessary, treatment will depend on various factors, such as:
- The size of the tumor
- Whether it is functioning or nonfunctioning
- The extent of the tumor (whether it has spread to surrounding areas or not)
- The age and overall health of the patient
Sometimes, the symptoms of functioning pituitary tumors can be treated using medication that restores the balance of hormones in the body. Medication is very useful for treating acromegaly and Cushing’s disease.
"Extensive neurosurgical and medical experience in management of pituitary tumors leads to better outcomes." - Dr. Susmeeta Tewari Sharma, Director of Pituitary Endocrinology at the MedStar Pituitary Center
Successfully treating a pituitary tumor requires an experienced team of specialists. At MedStar Washington, we take a comprehensive, multidisciplinary approach to the diagnosis and treatment of pituitary tumors in order to achieve the best outcomes. We are the only multidisciplinary pituitary tumor center in the Washington, DC, area to have neurosurgeons experienced with pituitary disorders, a pituitary endocrinologist, a neuro ophthalmologist, otolaryngology, office visits, diagnostic testing, and surgery - all in the same location.
Surgical Treatment for Pituitary Tumors and Post-Treatment
If the tumor is symptomatic, surgical intervention to remove the tumor will be necessary. There are two surgical techniques that can be used to remove a pituitary tumor. The technique used will depend on the size, extent, and the location of the tumor.
Transsphenoidal surgery - Transsphenoidal techniques use endoscopic instruments to remove the pituitary tumor through the nasal cavity. This type of surgery minimizes risks associated with more invasive, open surgical procedures.
Transcranial surgery - Transcranial surgery is an open surgical technique where the pituitary tumor is removed through an opening in the skull. This type of surgery is used for larger pituitary tumors that have spread to surrounding areas.
If the tumor cannot be removed, radiation therapy may be used to shrink the tumor. Radiation therapy can also be used in conjunction with surgery in order to target the tumor.
Some patients may experience sinus pressure and/or congestion for a few weeks following surgery. After surgery, some individuals may need adjuvant radiation and/or medication therapy in order to completely remove the tumor and restore hormone levels in the body.
Outlook and Prognosis for Individuals With Pituitary Tumors
When diagnosed and treated early, individuals typically experience excellent outcomes. However, if the tumor is diagnosed after it has spread or if it is left untreated, it may cause serious health complications. Lifelong treatment may be required in order to maintain hormonal balance. It may also be necessary to continue follow-up care indefinitely in order to monitor for the return of the tumor. It is very important to carefully follow instructions given by the pituitary tumor care team.